E-stim Parameters

NMES

E-Stim for muscle strength

NMES pulse frequency

35-80 pps

NMES amplitude

Injured > 10% MVIC

Uninjured > 50% MVIC

NMES on:off time

Initially 1:5 ratio

6-10s ON : 50-120s OFF

NMES treatment time

10-20 min to produce 10-20 reps

NMES # times/day

Every 2-3 hrs while awake

Pulse Duration (all e-stim)

Small muscle = 125-200 ms

Large muscle = 200-350 ms

Pulse Frequency (all e-stim except NMES)

35-50 pps

FES

Muscle re-education

FES amplitude

Enough for functional activity (e.g., foot drop)

FES on:off time

Depends on activity (e.g., foot drop - on time during swing phase)

FES treatment time

Depends on functional activity

Reduce Muscle Spasm - amplitude

Until muscle visibly contracts

Reduce Muscle Spasm - on:off time

2-5s on : 2-5s off (equal on and off)

Reduce Muscle Spasm - treatment time

10-30 min

Reduce Muscle Spasm - times/day

Every 2-3 hrs until spasm relieved

Reduce edema using muscle pump - frequency, duration, amplitude, on:off

Same parameters to reduce muscle spasms

Reducing edema using muscle pump - treatment time

30 min, 2x/day

Frequency

Pokes/sec

Duration

How long each poke is

Ramp up time

How long until peak intensity

Pt comfort - frequency

Low frequency = uncomfy

High frequency = more comfy

Pt comfort - ramp up time

Longer ramp up = more comfy

MVIC

Max Voluntary Isometric Contraction

Pt Comfort - Pulse duration

decrease

(Decrease duration to decrease discomfort)

Pt Comfort - Electrode size and quality

Big and Sticky

Pt Comfort - On:Off time

increase off time

E-stim Contraindications

Please Understand Currents Threaten Pregnancy

P - Pacemaker

U - Unstable arrhythmias

C - Carotid Sinus

T - Thrombosis

P - Pregnant (near uterus)